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  • 1
    Electronic Resource
    Electronic Resource
    Ganglioglioma: a detailed histopathological and immunohistochemical analysis of 61 cases (1994)
    Springer
    Acta neuropathologica 88 (1994), S. 166-173 
    Details
    ISSN: 1432-0533
    Keywords: Key words: Ganglioglioma ; Hamartia ; Proliferation ; Ki-67 ; p53
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Gangliogliomas are tumors composed of intimately admixed neuronal and glial components and account for approximately 1   % of all brain tumors. Here we report the histopathological findings in 61 gangliogliomas. Epilepsy was the most common presenting symptom. Most gangliogliomas were located in the temporal lobes (74 %). Thirteen percent of the gangliogliomas were associated with glioneuronal hamartias. There was considerable variation in neuronal size and density, presence of binucleated neurons, calcifications, desmoplasia, lymphocytic infiltrate, pilocytic differentiation, Rosenthal fibers, location, or histological uniformity. Fifteen percent of the gangliogliomas contained areas of purely astrocytic differentiation. All tumors were examined immunohistochemically for an aberrant p53 tumor suppressor gene product and for the presence of nuclear antigens associated with cell proliferation (Ki-67, Ki-S1, proliferating cell nuclear antigen). In 45 of 61 cases (74   %) labeling indices for Ki-67 were less than 1   %. Nuclear labeling for Ki-67 was observed exclusively in the astrocytic component. Gangliogliomas with very large neurons had higher Ki-67 labeling indices and occurred in younger patients than gangliogliomas with small – or intermediate – sized neurons. None of the tumors had an aberrant expression of p53. The observations suggest that gangliogliomas may arise from glioneuronal hamartias through neoplastic transformation of the astrocytic component.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00294510
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  • 2
    Electronic Resource
    Electronic Resource
    Prognostic value of somatosensory- and motor-evoked potentials in patients with a non-traumatic coma (1988)
    Springer
    European archives of psychiatry and clinical neuroscience 237 (1988), S. 184-187 
    Details
    ISSN: 1433-8491
    Keywords: Non-traumatic coma ; Somatosensory-evoked potential ; Motor-evoked potential
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A total of 28 patients with non-traumatic coma were studied both with somatosensory- and motor-evoked potentials. While somatosensory-evoked potentials (SEP) have proved to be useful in predicting the outcome in patients with severe brain damage, the aim of this study was to find out whether the additional evaluation of motor-evoked potentials (MEP) could contribute to a better prediction of the outcome than SEP alone. Our results clearly indicate that in terms of prognostic value, SEP are superior to MEP. Nine patients with bilaterally preserved MEP died, while all of the patients with bilaterally preserved SEP and a central conduction time ≤ 6.5 ms survived, with a Glasgow outcome score of 1 to 3. Therefore, we cannot recommend the inclusion of MEP in the prognostic evaluation of patients with non-traumatic coma.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00451288
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  • 3
    Electronic Resource
    Electronic Resource
    Pituitary adenoma and meningioma in the same patient (1989)
    Springer
    European archives of psychiatry and clinical neuroscience 238 (1989), S. 144-148 
    Details
    ISSN: 1433-8491
    Keywords: Pituitary adenoma ; Meningioma ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Three patients are presented in whom both pituitary adenoma and meningioma were found. The pituitary tumour was a prolactinoma in one case and non-secreting adenoma in the other two. In one case the meningioma originated from the planum sphenoidale and was seperate from the pituitary adenoma. Another patient had a parasellar meningioma, which was suspected preoperatively by different enhancement on the CT scan. In the third case, both tumours were mainly infradiaphragmatic and could not be differentiated preoperatively or intraoperatively. This appears to be the first case with both tumours below the diaphragm. The clinical, radiological and histopathological findings are presented.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00451002
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  • 4
    Electronic Resource
    Electronic Resource
    Do motor evoked potentials allow quantitative assessment of motor function in patients with spinal cord lesions? (1992)
    Springer
    European archives of psychiatry and clinical neuroscience 241 (1992), S. 201-204 
    Details
    ISSN: 1433-8491
    Keywords: Motor evoked potential ; Spinal cord lesion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Motor evoked potentials (MEP) were recorded in a total of 110 patients with tumorous (n=39) and non-tumorous (n=71) lesions of the cervical (n=59), thoracic (n=37) and thoracolumbar (n=14) spinal cord. In all cases MEP were elicited by electrical stimulations, and in 50 of them also by magnetoelectric stimulation, of the motor cortex. The peripheral conduction time was determined by electrical stimulation of the lumbar nerve roots. It was the aim of this study to determine whether 1. MEP are sensitive for detection of lesions along the spinal cord and 2. whether they allow quantitative assessment of motor function. To achieve this goal, we compared potential and clinical findings of our patients, each divided into seven categories. Our results clearly showed the high sensitivity of MEP for semi-quantitative evaluation of motor function, as there were no false negative results in our series. Moreover, unilaterally accentuated motor deficits correlated significantly with changes in MEP, which were affected more strongly on the corresponding side (Student'st-test, α=0.05). However, clinical and electrophysiological findings did not correlate in the quantitative evaluation of the motor status as established by variance analysis (F=0.52). There was no difference in results with respect to the electrical and magnetoelectric stimulation technique. Our results lead to the following conclusions. MEP are sensitive for semiquantitative evaluation of spinal motor function; however, MEP do not allow quantification of the clinical motor status. We hypothesize that MEP changes are related more closely to the type of spinal cord damage (demyelination vs axonotmesis) and the duration of disease than to the actual clinical motor function.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02190253
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  • 5
    Electronic Resource
    Electronic Resource
    Neuronal loss and gliosis of the amygdaloid nucleus in temporal lobe epilepsy (1997)
    Springer
    Acta neuropathologica 93 (1997), S. 606-610 
    Details
    ISSN: 1432-0533
    Keywords: Key words Ammon’s horn sclerosis ; Amygdala ; Hippocampus ; Pathology ; Seizures
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Although clinical and electrophysiological evidence indicates that the amygdaloid body plays an important role in the pathogenesis of temporal lobe epilepsy, there are very few detailed data on histopathological changes in this nucleus in epilepsy patients. In the present study we have examined the lateral nucleus of the amygdaloid body in 70 surgical specimens from patients with temporal lobe epilepsy and in 10 control specimens with respect to neuronal density and gliosis. The results were compared to the neuronal loss in the hippocampal formation. Our goal was to examine the pathological alterations of the amygdaloid body and their correlation with other morphological changes in temporal lobe epilepsy. In epilepsy patients with Ammon’s horn sclerosis or focal lesions of the temporal lobe, the neuronal density of the lateral amygdaloid nucleus was significantly decreased as compared to normal controls (P 〈 0.001). Overall, the mean volumetric density in epilepsy patients was reduced to 59% of that in normal individuals. There was no correlation between the neuronal density in the lateral amygdaloid nucleus and that in the different segments of the hippocampal formation or to the age at onset or the duration of epilepsy. The neuronal loss of the amygdaloid nucleus correlated well with the presence of fibrillary gliosis. Our findings demonstrate that the amygdaloid body is severely altered in most patients with temporal lobe epilepsy and that these changes are independent of those in the hippocampus. The presence of neuronal loss and gliosis in the amygdaloid nucleus of patients with focal lesions but no Ammon’s horn sclerosis is compatible with an involvement of the amygdala in secondary epileptogenesis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004010050658
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  • 6
    Electronic Resource
    Electronic Resource
    Antibiotic prophylaxis in cerebrospinal fluid shunting: a prospective randomized trial in 129 patients (1995)
    Springer
    Neurosurgical review 18 (1995), S. 169-172 
    Details
    ISSN: 1437-2320
    Keywords: Antibiotic prophylaxis ; cefotiam ; CSF-shunting ; infection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The efficacy of a single dose of cefotiam, a cephalosporin of the second generation, as prophylaxis for postoperative infection was analyzed in a prospective randomized study of 129 patients undergoing cerebrospinal fluid shunting. The main focus of interest was the rate of shunt infection requiring operative shunt removal. Data were evaluated in the total group and subgroups formed for normal and high risk patients, respectively. The overall rate of shunt infection was 7.5% in the cefotiam group and 12.9% in the control group. In the high risk subgroup infection rate was 14.3% with and 26.3% without cefotiam as opposed to 4.3% and 6.9%, respectively, in the normal risk subgroup. Although our results do not reach statistical significance, there is a noticeable difference of infection rate between those patients who receive the antibiotic and those who do not. Therefore, we favor single dose antibiotic prophylaxis in shunting procedures.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00383721
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  • 7
    Electronic Resource
    Electronic Resource
    Motor evoked potential monitoring during neurosurgical operations on the spinal cord (1991)
    Springer
    Neurosurgical review 14 (1991), S. 29-36 
    Details
    ISSN: 1437-2320
    Keywords: Motor evoked potential ; spinal cord surgery ; transcranial electrical stimulation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In order to monitor descending pathways during neurosurgical operations on the spinal cord, motor evoked potentials (MEP) were recorded from the epidural space of the spinal cord and the cauda equina following transcranial electrical cortex stimulation in a total of 40 patients. It was the aim of our study to test this invasive recording technique with regard to recordability of potentials as well as correlation to post-operative neurological conditions. In 15 of 23 patients (65.2%) intraoperative potentials were obtained from the spinal cord and in 33 of 40 patients (82.5%) they were obtained from the cauda equina. On the basis of acceptable changes in amplitudes of up to 50% at the end of the operation, 13 of 15 (86.7%) recordings from the spinal cord and 28 of 33 (84.8%) from the cauda equina correlated correctly with the post-operative motor status. At the same time, there were false positive results in 2 (13.3%) and 5 (15.2%) recordings, respectively. False negative results were not observed. Post-operative deterioration of the motor status as observed in 3 patients coincided in 2 patients with a permanent reduction in amplitudes of more than 50% of the baselines and in 1 patient with an intra-operative loss of potentials. Thus both spinal cord and cauda equina recording of MEP clicited by transcranial electrical stimulation were proven to be sensitive methods for detection of impending neucological complications. Cauda equina recording, however, seems to allow recording in more cases.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00338189
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  • 8
    Electronic Resource
    Electronic Resource
    Diagnosis and treatment of frontobasal skull fractures (1997)
    Springer
    Neurosurgical review 20 (1997), S. 19-23 
    Details
    ISSN: 1437-2320
    Keywords: Computerized tomography ; skull fracture
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract During a five-year-period (January 1990 to December 1994) a total of 67 patients were operated on for frontobasal skull fractures. The indication for surgical treatment was based on the evidence of fractures encroaching paranasal sinuses or the cribriform plate on high-resolution axial or coronal CT scans. The following clinical signs indicating frontobasal trauma were observed: 25 patients (37%) showed rhinoliquorrhea, 14 (21%) had racoon's eyes, and 2 (3%) had meningitis. Distinct dura laceration was observed intraoperatively in 64 of 67 patients (96%). In our experience, high resolution CT has proven to be a sensitive diagnostic tool for frontobasal skull fractures. With respect to the high coincidence of fractures and dura lacerations, the indication for surgical treatment based on CT findings seems to be justified.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01390521
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  • 9
    Electronic Resource
    Electronic Resource
    Surgical management of brain-stem cavernomas (1997)
    Springer
    Neurosurgical review 20 (1997), S. 87-93 
    Details
    ISSN: 1437-2320
    Keywords: Brain-stem cavernoma ; microsurgery ; monitoring
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present a series of seven patients who were operated on for symptomatic brain-stem cavernomas. The following approaches were used: medial suboccipital (N = 4), lateral suboccipital (N = 1), subtemporal-transtentorial (N = 1), and frontal transcortical-transventricular-subchorioidaltrans velum interpositum (N = 1). Intraoperative motor (N = 4) and somatosensory (N = 1) evoked potential monitoring revealed temporary changes in 3 patients. Immediately postoperatively, the following additional deficits were observed in 6 patients: oculomotor nerve paresis (N = 2), abducens nerve paresis (N = 3), facial nerve paresis (N = 2), deafness (N = 1), and increased ataxia (N = 3). One patient died due to septic complications not related to surgery. After a mean observation time of 2 years, 2 patients had improved, 3 were unchanged, and 1 patient deteriorated as compared to his preoperative status. In conclusion, surgical treatment of brain-stem cavernomas, although carrying a significant risk of temporary neurological deterioration is recommended in symptomatic patients in whom the cavernoma seems to reach the surface of the brain-stem. Intraoperative functional topographic mapping and monitoring have proven useful tools lowering the surgical risks in these patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01138189
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  • 10
    Electronic Resource
    Electronic Resource
    Percutaneous needle trephination for external CSF drainage: experience with 226 punctures (1995)
    Springer
    Neurosurgical review 18 (1995), S. 31-34 
    Details
    ISSN: 1437-2320
    Keywords: External CSF drainage ; percutaneous needle trephination
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report on our experience with 226 percutaneous needle trephinations in a total of 192 consecutive patients. Trephination was performed with a hand-driven drill. A special puncture needle was inserted into the anterior horn of the lateral ventricle. The main indication for this procedure was the treatment of occlusive hydrocephalus in an emergency. Duration of drainage ranged from 1 to 34 days and was 7 days on the average. We encountered 14 cases of infection (6.2%) and one case of symptomatic bleeding (0.4%). All these complications eventually resolved without permanent sequelae. In our opinion, ventricle puncture with this device is a simple and effective method and can especially be recommended for external CSF drainage in cases of emergency.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00416475
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